Jonathan Bricker, psychologist and smoking cessation researcher

Helping people overcome behaviors that increase cancer risk

By combining cutting-edge psychology and technology, Dr. Jonathan Bricker is working to help millions of people adopt healthier habits that reduce their cancer risk.

“Most people don’t think of cancer as a behavioral problem,” says Bricker, a psychologist in Fred Hutch’s Public Health Sciences Division, “but whether it’s by quitting smoking or losing weight or exercising more, there are some definitive things you can do to reduce your risk and thereby live a longer and higher-quality life.”

Bricker leads a multi-study research program that uses an innovative paradigm, called Acceptance and Commitment Therapy (ACT), to help participants overcome the urge to smoke. ACT encourages people to notice and accept their urges to smoke, with the understanding that they will disappear on their own. For instance, people learn skills such as stepping back, observing their urges, and likening them to leaves floating down a stream. This is a radical departure from traditional smoking-cessation programs, which encourage people to avoid and suppress smoking urges.

“Practicing acceptance can be a real eye-opener – a lot of people are relieved when they realize their urges are temporary and they don’t have to work so hard fight them,” Bricker says.

In one clinical trial, Bricker and his colleagues found that 30 percent of participants who followed an ACT approach in group therapy sessions were able to quit smoking, vs. just 13 percent of participants who practiced the traditional avoidance approach.

Now Bricker’s team is building on that success by developing and testing WebQuit, a free website that guides smokers through ACT-based approaches. WebQuit helps users develop personalized quit plans, offers tutorials that teach people to allow their cravings to fade away, and lets users upload photos of their families, favorite places, and anything else that illustrates their commitment to quitting.

Bricker recently completed a pilot study that takes this research to the next technological level by testing a smartphone app. The app has features like push notifications that invite users to watch video tutorials or track how well they accept their cravings.

“Technology helps us extend our reach to people who might never have access to standard counseling,” Bricker says.

If the studies confirm that ACT is more effective than traditional approaches – which work for only about 15 percent of people who use them to stop smoking – Bricker envisions applying ACT to other behaviors that increase cancer risk. That means the smoking-cessation studies are now a gateway toward exploring whether ACT can help people overcome obesity, alcohol abuse and other behaviors that increase their risk for cancers, heart disease and other serious health problems.

“This is a potentially groundbreaking model,” Bricker says, “and we’re really excited about the possibility of impacting a lot of other behaviors.”

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